The play with words on ICU (Intensive Care Unit of the hospital) is not to extract humor on an otherwise somber and frightening experience when one must deal with a loved one admitted to any place of emergency care, but it is a way to express my version of a comic relief from the experience because in the end it would be all just fine; albeit, the road ahead is lined with a series of home health care visits and physical therapy.
My wife had to be transferred posthaste from the emergency unit of the hospital near where we live to the Texas Medical Center in Houston. Now, let me set that aside for the moment, although I will touch on it later, after I go through recounting a series of mis-adventured and miscued moments that, thankfully in retrospect, happened to me rather than at the ICU. This is also an homage to the medical profession and those who over many decades had the vision to build the medical complex I will talk about in the coming paragraphs.
The Texas Medical Center (TMC) is famous for being the largest medical complex in the world. In the early seventies, long before the concept of medical complexes began to develop in other countries, this was the place where the most challenging medical cases were flown in from all corners, and a frequent destination of rich patients particularly from oil rich countries (the 70s remember) for their medical needs. Rare and obscure cases that were new to and of value to medical science, regardless of financial considerations, had a place in the research units of the hospitals as well.
Today, TMC is even bigger and leads in medical breakthroughs - from cancer research to advances in medical procedures (organ transplants, microsurgery and the development of intricate medical devices, etc.).
It is huge. On a "given" day, the number of hospital personnel (doctors, nurses, technicians, support staff from other services), patients and their relatives, hotel workers, etc., would make for a small town or city. But if we base it on its energy needs, water and trash services, and the number of standby generators that are as ubiquitous as the industrial AC units on every building's rooftop, it would be a decent-size metropolis.
Hotels that are part of the landscape of this complex directly or peripherally around a 2-3 mile radius may have as many rooms as there are hospital beds, if not more so, because patients' families from all over the USA and other countries need places to stay. The number for multi story garages have parking spaces equivalent to the parking lot of a large mall, or that of a major professional sports stadium.
Parking poses the first significant challenge to anyone who ventures into the TMC. I, who had been through here at least three times years ago, though at multi year intervals in between each visit, should know better. I still didn't. And we live in the area.
I drove my car as my wife was taken by ambulance during the transfer. I circled a couple of times to get to a parking garage. I turned into a succession of levels before getting a spot at Level 4 and felt lucky it was by the elevator. Level 4, R4, fortunately I thought, was easy to commit to memory, concluding that there were at least four different zones at Level 4. I got on the elevator and pressed 1. Moments later I felt it stopped but the door in front of me and where all the buttons I pressed didn't open.
I waited a few more seconds facing the door when I heard a voice, "May I help you sir?" I looked up to the top left corner of the elevator where I thought the source of the voice came from, which I assumed was a security camera. I replied, "I'm trying to get out of this elevator but the door won't open"
Then I heard the same voice, "Sir, sir, why don't you turn around?" I did. The elevator was one of those that opened at one or the other side depending on how it emptied into the particular floor. I turned and there were 5 people looking at me waiting at the lobby. Frustration quickly turned to embarrassment though now I think it was hilarious. Picture this: Five people watched the elevator open and saw a man with his back turned to them talking to the upper left corner of the elevator. They had stories to tell their friends that day.
One of the five gentlemen with a clipboard remained standing while the other four went into the elevator. He spoke to me politely, "What floor are you headed to, sir, and do you know the patient's name? I replied, "All I know is that my wife was taken by ambulance from St. Luke's at Sugar Land to be brought here". He said, "Sir, this is M.D. Anderson Cancer Center. She must have been brought to St. Luke's Baylor. Not to worry, go out those glass doors and you'll see it".
Embarrassed again, I headed to and went out the glass door. In the glare of the sun, a huge building emblazoned with St. Luke's Baylor on its façade was two blocks away. The temperature that day was 101 F, so the building might as well have been a mirage; the concrete crosswalk might as well have been the Sahara. I just exaggerated but a state of mind is a state of mind.
From the information desk of St. Luke's I was told to take the yellow elevator, 6th floor. Elevators are color-coded! Through a labyrinth of seemingly endless hallways I went through blue, purple, then at last I got on the designated elevator, or so I thought. I got off the 6th floor and asked the person at the nurse station. I said, "I was told to go to the Dooley wing on the 6th floor. She replied, "There is no Dooley wing in the hospital. Oh, did you mean the Cooley wing?" Of course, it was Denton Cooley the wing was named after. Dr. Cooley was the surgeon who implanted the first truly artificial heart in 1970.
As a side note,
"Cooley reportedly answered in the affirmative when a lawyer during a trial asked him if he considered himself to be the best heart surgeon in the world.
Don't you think that's being rather immodest? the lawyer replied.
"Perhaps," Cooley responded. "But remember I'm under oath."
The nurse told me to go back down and take the yellow elevator. "You were on the orange one". I did make it to the right wing and floor at last. Again, I will hold off for a few more while and I promise I will get to it because the condition my wife experienced which I will be describing could be of special interest to the readers.
It was almost 9:00 p.m. before I headed out for home. The ICU has no accommodation for a bed for a relative to stay overnight. I was tired and emotionally drained to find my way back to the dreaded "wrong" parking garage. I took the elevator and pressed 1. When it opened, it was not the lobby but a concrete hallway that was dusty and empty. When I turned around, there was no call button for the elevator, except for a stenciled sign that said "NO Re-Entry". There were steel stairs up and down from the floor. I just then realized that it was the service elevator I just took. Going up the stairs, the floor was filled with broken beds and furniture. The door was locked. I was at the hospital's basement/repository of old and abandoned equipment and furniture. I retraced my steps and went one more stairwell down. There was a door with a push bar. I pushed and it opened up. I was looking down the edge of an elevated inclined hedge row of ivy, five feet above from the sidewalk. I gingerly managed to get to the sidewalk to the astonishment of those walking by. That was the side fire exit of the hospital's basement that I exited from.
Exhausted and worried about my wife, I barely managed to take a shower before hitting the bed. The ripened papaya at the kitchen counter that needed to be sliced before storing in the refrigerator had to wait another day. Two Cornish hens that were thawing in the fridge will too have to wait their turn for a culinary disposition of my choice, later. Despite the trepidations around my wife's medical predicament I slept for six hours straight. I beat the alarm radio.
The routinary habit kicked in. Two scoops of ground coffee into the coffee maker, then the right amount of water were poured into the side receptacle, then I went about preparing what I needed to take with me to the hospital. I wanted to be there by 7:00 A,M. to beat the traffic. The aroma of coffee was particularly strong as I was moving about. Then I knew why. I forgot to put the coffee pot under. Coffee was not coming through the spring loaded drip spout but there was plenty of it overflowing the filter basket into the sides and spreading like an ink blot on the white Formica countertop.
It was a mess to clean up but I managed to brew another pot. I poured it carefully into a large insulated Yeti coffee mug. Checking to make sure the house was secured and making a point to see the garage door shut, I drove away. A mile into the freeway, cruising through light traffic and feeling good about it , I instinctively reached for the mug at the usual cup holder when I realized it was still sitting at the kitchen counter at home. Driving through the freeway sans coffee in the morning turned out to be a much calmer experience than I expected. I had to force myself to be calm because I knew the streak of mishaps had to stop smearing the day. The next few miscues during the week were not too bad and no longer deserve any more attention. But suffice it to say, whatever advances achieved through medical research, hospital cafeteria food remains pristinely untouched by any new development. Hospital food's advancement is decidedly frozen in time, unencumbered by even a hint of telltale progress. But, in defense of the hospital, any hospital, it is in the business of healing and not striving to be a gourmet provider. Besides, often it is the least in the patients' list of aspirations anyhow.
My wife had been complaining of a sore throat for days. Three trips to the urgent care center (it was on Friday afternoon through the weekend) made indiscernible improvement. On Wednesday morning, I called 911 because she complained about severe pain in her throat and she lost her speaking voice above a whisper. The EMT folks came quickly but when her vital signs and EKG proved she was not having a heart attack or stroke, they recommended that we see her doctor that morning right away. There was nothing they could do about her sore throat.
We were at the doctor's office at eight and by nine she decided my wife should be admitted to the hospital. St. Luke's at Sugar Land was seven minutes away. We drove there ourselves. They took all the necessary procedures and checks and a shot of antibiotics. By early afternoon, the emergency doctor decided she should be taken by ambulance to the Texas Medical Center, St. Luke's Baylor.
I was shocked and concerned that the floor she was taken to was the Intensive Care Unit (named after Dr, Cooley). When I got to her room, she had plastic tubes to both her arms and an oxygen mask over her face. I learned they were pumping massive amounts of antibiotics and steroids intravenously. Her neck was swollen red and tender to the touch. There was like half a baseball under her chin. The antibiotics and steroids were given to her every six hours.
By the following day, the swelling dramatically subsided and the redness was gone. The EENT doctor made regular visits, using a laryngoscope through my wife's nostrils into her throat to assess progress.
After two days at the ICU, she was moved to the "step down" room at a different wing of the hospital. Remember the orange elevator? That was the first wing I went up to first by mistake. Antibiotics continued plus a continued lower dosage of steroid. To help with her breathing she was hooked to a nebulizer for seven minutes every four hours.
It was only later at discharge that we knew what it was she suffered from. It was acute epiglottitis. From one reading material I read that it was suspected to have caused the death of George Washington. Most of the reading material focuses on pediatric incidences and only rarely on adults.
"Epiglottitis is the inflammation of the epiglottis—the flap at the base of the tongue that prevents food entering the trachea (windpipe). Symptoms are usually rapid in onset and include trouble swallowing which can result in drooling, changes to the voice, fever, and an increased breathing rate".
Put simply, the wonder of human physiology dictates that in breathing, the flap opens to let air through to the trachea, then to the lungs. When swallowing liquid or food, the flap closes to direct both through the esophagus, then to the stomach. The swelling from a bacterial infection causes all kinds of issues with the flap of tissue either not sealing properly or obstructing the trachea. It is mostly a pediatric ailment because that part in children may not yet have developed to the proper size (mostly larger at birth).
The decision by the doctors - first in sending her immediately for admission, then followed immediately by the quick transfer to the main facility at the TMC - was crucial. Of course, the nurses and doctors at the ICU knew just what to do and the hospital was well equipped with the necessary tools and medication. I try to imagine what this would have been like in less developed countries. Naturally, arriving at the proper diagnosis in the amount of time that it took was too very critical.
Follow up home health visits will ensure no re-infection or other complications to ensue, while physical therapy will help her regain the strength lost while bed-bound for six days, largely because of her age and Parkinson's.
There is so much to be grateful all around. There was science in one hand. But I must admit I felt the prayers of friends and family paved the path for the body's responses.
She was discharged on July 3, so we spent July 4th at home to watch the fireworks on TV. That was the first time in almost two decades that we missed spending July 4th at a friend's home ( a high school classmate) whose family opens up their home and their backyard pool to watch the fireworks with friends every year, with plenty to eat from noon till late.
However, there was something very special that night of July 4, with just my wife and me. She still had no appetite so I didn't even attempt to prepare a sumptuous meal. I must say that was the best July 4th ever, for just the two of us together with little festivities except what we inwardly felt deep inside - gratitude for God's benevolence and the advances made possible in the medical field at this particular time in human history that we all live in.
Our hopes, wishes and prayers go out to everyone from all corners of the world who at this moment is facing health challenges of any kind.
No comments:
Post a Comment